scholarly journals 565 Follow-Up of Neonatal Nonhaemolytic Hyperbilirubinemia in Danish Term and Near-Term Infants with Total Serum Bilirubin Level ≥ 420 Umol/L

2010 ◽  
Vol 68 ◽  
pp. 289-289
Author(s):  
P K Vandborg ◽  
G Greisen ◽  
B M Hansen ◽  
F Ebbesen
2021 ◽  
Author(s):  
Biruk Hailu Tesfaye ◽  
Mulugeta Betre Gebremariam ◽  
Abiy Seifu Estifanos ◽  
Asrat D. Gebremedhin

Abstract Background: Delayed cord clamping (DCC) above one minute is associated with nutritional and developmental benefits newborns. DCC could also lead to elevated serum bilirubin, leading to jaundice that require phototherapy at the early ages of life. However, evidence on the relationship between DCC and outcomes is limited in resource-limited settings.Objective: To evaluate the effect of the time of cord clamping on serum bilirubin level at 24 hours post-birth in an Ethiopian Tertiary Care hospital.Methods: A three-arm, single-blind, randomized controlled trial was conducted between October 2019-January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following interventions depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 sec), and delayed cord clamping (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed at 24-hour after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of participants, while linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. STATA version 14 was used for statistical analyses.Result: A total of 141 term newborns were included and randomized into the three categories. Demographic, social and obstetrics factors of the women were not different across groups except labor duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours post-birth, whereas cord blood total serum bilirubin (coef. 0.24; p<0.05) and bilirubin nomogram high-risk zone (Coef. 6.25; p<0.001) were significant predictors.Conclusion: Time of umbilical cord clamping has no effect on the total serum bilirubin level of neonates at least within 24 hours of birth.


1976 ◽  
Vol 4 (4) ◽  
pp. 241-246 ◽  
Author(s):  
D I Conway ◽  
M D Read ◽  
C Bauer ◽  
R H Martin

The total serum bilirubin levels at two and occasionally five days after birth were studied in 162 infants whose mothers received either intravenous oxytocin or oral Prostaglandin E2 during labour, and the results were compared with those obtained in forty-two control patients. Following labour of spontaneous onset, whether the mother received intravenous oxytocin or oral Prostaglandin E2, neonatal total serum bilirubin levels were not different from those in controls. After induction by amniotomy and an active agent, higher mean total serum bilirubin levels were found in infants whose mothers received intravenous oxytocin than in those given oral Prostaglandin E2; a significant rise in the total serum bilirubin level appeared to occur when mothers received a total of more than 12,000 milliunits of oxytocin or more than 4,000 milliunits per kg birthweight of the infant.


Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous


2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Alireza Sadeghnia ◽  
Nasrin Hashemian Nejad ◽  
Shadi Noorizadeh ◽  
Ehsan Shahrestanaki ◽  
Zahra Jamshidi ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
pp. 35-38
Author(s):  
Murshida Mosharref ◽  
Naila Rehnuma ◽  
Nusrat Jahan ◽  
Farzana Zafreen

Introduction: Hyperbilirubinemia is a common problem in the neonatal period. Phototherapy is the most important proposed treatments for hyperbilirubinemia, but several drugs along with phototherapy are used with recent advances. Aim: To see the effect of oral fenofibrate on serum bilirubin level in term neonates with unconjugated hyperbilirubinaemia. Methods: This prospective study was carried out in Combined Military Hospital Cumilla from July 2018 to June 2019. Total 60 term and normal birth weight neonates with neonatal jaundice were enrolled in this study. Jaundiced newborns presenting with infection, G6PD deficiency, conjugated bilirubin >2 mg/dl or >15% of total serum bilirubin (TSB) and congenital anomalies were excluded from this study. These neonates were randomly allocated to the Fenofibrate group (30 cases) and Control group (30 cases). Total serum bilirubin was measured every 24 hours till the end of phototherapy and at the time of discharge. Statistical analysis was done using SPSS 22.0 and p<0.05 was considered significant. Results: There were no significant differences in gender, age, weight, gestational age and type of delivery between two groups. Mean duration of hospital stay were 4.0±0.7 and 5.5±1.4 days in Fenofibrate group and Control group respectively (p<0.001). In Fenofibrate group, TSB was decreased from 17.2 mg/dl to 15.2 mg/dl after 24 hours, to 13.6 mg/dl after 48 hours, and to 10.1 mg/dl at the time of discharge.  In control group, TSB was decreased from 17.0 mg/dl to 16.3 mg/dl after 24 hours, to 15.9 mg/dl after 48 hours, and to 10.3 mg/dl at the time of discharge. Conclusion: Treatment of neonatal unconjugated hyper- bilirubinemia with fenofibrate reduces neonatal bilirubin levels and decreases the need for phototherapy and hospitalization. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 35-38


2021 ◽  
Author(s):  
Biruk Hailu Tesfaye ◽  
Mulugeta Betre Gebremariam ◽  
Abiy Seifu Estifanos ◽  
Asrat D. Gebremedhin

Abstract Background Delayed cord clamping (DCC) above one minute is associated with nutritional and developmental benefits for newborns. DCC could also lead to elevated serum bilirubin, leading to jaundice that require phototherapy at the early ages of life. However, evidence on the relationship between DCC and outcomes is limited in resource-limited settings. Objective To evaluate the effect of the time of cord clamping on serum bilirubin level at 24 hours post-birth in an Ethiopian Tertiary Care hospital. Methods A three-arm, single-blind, randomized controlled trial was conducted between October 2019-January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following interventions depending on the timing of cord clamping: immediate cord clamping (< 30 seconds), intermediate cord clamping (60 sec), and delayed cord clamping (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed at 24−hour after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of participants, while a linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. STATA version 14 was used for statistical analyses. Result A total of 141 term newborns were included and randomized into the three categories. Demographic, social and obstetrics factors of the women were not different across groups except labor duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours post-birth, whereas cord blood total serum bilirubin (coef. 0.24; p < 0.05) and bilirubin nomogram high-risk zone (Coef. 6.25; p < 0.001) were significant predictors. Conclusion Time of umbilical cord clamping does not affect the total serum bilirubin level of neonates at least within 24 hours of birth.


2016 ◽  
Vol 50 (6) ◽  
pp. 351
Author(s):  
Ahmed Widiasta ◽  
Lelani Reniarti ◽  
Abdurachman Sukadi

Background Neonatal hyperbilirubinemia is commonly found in newborns. Assessment of the risk of hyperbilirubinemia and information on the average time of the occurrence of hyperbilirubinemia are important to prevent the development of severe hyperbilirubinemia.Objective To find out the incidence of and the time of the development of hyperbilirubinemia in healthy-term newborns.Method A cohort prospective study was done on healthy-term newborns born at Hasan Sadikin Hospital between November and December 2009. Subjects were divided into 4 groups of risk at discharged, based on Bhutani nonnogram. A serial bilirubin level measurement were perfonned within 6 days.Resu l ts One of 14 newborns at low risk group developed hyperbilirubinemia but did not need phototherapy. Six of 14 newborns at intermediate-low risk group developed hyperbilirubinemia, 2 of them needed phototherapy with total serum bilirubin level of 14.7 mg/dL at 57 hours and 19.8 mg/dL at111 hours. Nine of 15 newborns of intennediate-high risk group developed hyperbilirubinemia, 1 of them needed phototherapy with total serum bilirubin level of 16.6 mg/dL at 76 hours. There was no newborn cathegorized as high risk group in this study. The median time the occurrence of hyperbilirubinemia in intennediate-low and intennediate-high risk group was 140 hours and 82 hours, respectively. There was no significant difference in survival curve between intennediate-high and intennediate-low risk groups (95% CI 108.1 to 1 2 5.4).Conclusion The incidence of hyperbilirubinemia was not different between intennediate-low and intermediate-high risk babies.


2020 ◽  
Vol 11 (4) ◽  
pp. 58-63
Author(s):  
Pabitra Sapkota ◽  
Fakir Chandra Gami

Background: Neonatal jaundice is a commonly encountered condition in the neonates during first week of life. Early discharge of healthy term newborns is a common practice, because of the risk of nosocomial infections, social causes like in early naming ceremony, and also due to economical constrains. In significant number of newborns, neonatal hyperbilirubinemiais the most common cause for readmission. There is concern regarding early discharge of healthy term newborns due to reports of bilirubin induced brain damage resulting in sequel like kernicterus .There are reports of bilirubin induced brain damage  which occurred in healthy term neonates even without hemolysis and the clinical outcome could be serious. The need for early detection of hyperbilirubinemia in the newborns is therefore important. Aims and Objective: The objective of the study was to find whether cord blood albumin can be considered as a predictor of neonatal jaundice. The study also explored for any possible associations of different factors like gender, birth weight and mode of delivery with the occurrence of neonatal jaundice. Materials and Methods: The hospital based cross sectional study enrolled 100 healthy term newborns from August 2016-July 2017. Cord blood was sent for albumin level and blood group estimation. All babies were assessed for clinical jaundice using Krammer criteria and confirmed by estimation of total serum bilirubin level on the fourth day of life. Results: Correlation of cord blood albumin with the fourth day bilirubin level revealed negative correlation (r value of - 0.455) with p value of 0.000 which was highly significant. However, there was no correlation between cord blood albumin level with  total serum bilirubin level of more than 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion (p value of >0.005). Similarly, the study found no statistically significant association of neonatal jaundice with gender, weight and mode of delivery of the neonates. Conclusion: Cord blood albumin can be a risk factor rather than a diagnostic tool which can give a clue to possibility of high bilirubin level during neonatal period. There was no statistical significance seen between cord blood albumin level with total serum bilirubin level of ≥ 17mg/dl (neonatal hyperbilirubinemia) that required phototherapy or exchange transfusion. 


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